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If PNs in our study would, for any reason, not detect or not treat patients who are recruited for the effect evaluation on the basis of the researcher-led screening, it may become difficult to demonstrate the clinical effectiveness of SMS.
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"Drug companies can switch devices and use different combinations, and it becomes quite difficult to demonstrate equivalence," Dr. Norman said, adding that inhaler makers have exploited such barriers to increase sales of medicines long after the scientific novelty has passed.
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